Their concept was based on the fact that in CHF, left ventricular systolic dysfunction, high-grade intraventricular conduction delays are frequently observed: 25-50% of the patients have (IRS duration>120 ms and 17-25% of patients shows left bundle branch block (LBBB).

New analyses from a large study conducted in 2009, called MADIT-CRT, presented at the American College of Cardiology's 2014 Scientific Sessions in March, showed that CRT-D in patients with asymptomatic or mildly symptomatic heart failure (NYHA I/II) significantly reduces the risk of death or complications from heart failure when the patient has left bundle branch block, a condition that causes the left ventricle to contract later than the right ventricle.

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